I’ve attended over 100 births as a doula. If I decided, “Hey, I think I know a decent bit about childbirth. Why do the OBs and midwives get paid the big bucks? I think I’ll start catching the babies.” That. That would be a lay midwife. I would be a person without training hanging up my shingle. (*see footnote)

When I first read this bill, I thought the legislature’s intention was to criminalize, well, lay midwives (i.e. people who were DIY babycatching).

Surely they could not mean SC Licensed Midwives.

Then I read on.

Now, I realize it may be difficult for a layperson (pun intended) to understand the in’s and out’s of midwifery with it’s many acronyms and differences state-to-state. Let me break it down.

To apply the misnomer “lay midwife” to our licensed midwives is offensive. Simply that. And clearly the bill understands this offense as it belittles midwives and the families they serve by requiring a name tag (!): A lay midwife shall wear a clearly legible identification badge or other adornment at least one inch by three inches in size bearing the lay midwife’s name and the words ‘Lay Midwife.

Do you see the absurdity of this? These midwives are attending births primarily in homes. They have spent hours with the families they serve prior to the birth. Name tag?

Back to this lay midwife term. The bill defines lay midwife as a “midwife who may have had little formal training or recognized professional education in midwifery, who learned by accompanying doctors or midwives attending home births.”

Does that apply to SC Licensed Midwives? In the 1930’s, the state embarked on formal training of midwives. There were thousands of midwives practicing in rural areas, equipped by the SC government. In the 1970’s, a move (eerily similar to this one) ended government support of midwives. The people of SC reacted in protest and a new licensure program developed in the early 1980’s. This licensing process is still in place and ain’t broken. DHEC sets standards and regulations for midwives. Their outcomes are public information. Nobody is hiding anything.

A layperson can go to the DHEC website to view more information than s/he would ever want to know about regulations, current care providers, reporting, and more.

“Little formal training?” Licensed midwives must complete a formal education program approved by DHEC and finish an intensive clinical apprenticeship. Typically the preceptor-apprenticeship ratio is 1:1 or 1:2. It cannot be more than 1:3. The apprenticeship generally takes 2-3 years. Then the applicant completes an examination. Once licensed, there are continuing education requirements and peer review processes. And, of course, there are fees, fees, fees.

Calling Licensed Midwives “lay” would be the equivalent of suddenly calling all Licensed Builders in the state “lay” and requiring citizens to hire structural engineers to build their deck.

This bill will end the licensing of midwives in SC. It calls for direct supervision of “lay midwives” by obstetricians. Obstetricians and licensed midwives practice in different environments and under vastly different models of care. Don’t let the wording fool you, this bill would end legal midwifery for out of hospital birth in SC. This supervision wording is merely a smokescreen.

What will happen if there are no licensed midwives in SC? There will always be families who don’t want a medical birth. There will always be families who choose homebirth. And there will, I trust, always be midwives who will serve them. But these midwives will do so under the threat of criminalization.

There are many other issues associated with this bill:

Financial considerations: a homebirth with a licensed midwife typically costs less than 4000. An uncomplicated vaginal birth at the hospital may cost 10,000. Medicaid reimburses licensed midwives.

Freedom: this bill removes access to professional midwives. It will destroy an entire profession in our state; a profession recognized world-wide. If you care about freedom, this bill is one to fight.

Safety: I would need to write an entire post to discuss this one! This bill is not about the safety of mothers and babies.

So now, what will you do dear layperson? I saw a few weeks ago how a rapid response from citizens pressured the sponsors of a homeschool bill to remove their support. We can make that happen here, too.

Write, email, call the members of the 3M committee. Let them know you oppose this bill. You don’t need to write or say anything fancy. I think numbers are more important at this stage.

Please help SC families who want access to licensed midwives and protect our freedom to choose where and with whom to birth.

*There are many wise and experienced midwives who choose not to license. Some have called them “lay midwife.” I do not because I think the whole term “lay midwife” is oxymoronic. This bill isn’t addressing these unlicensed midwives anyhoo. It is addressing SC licensed midwives.

I strongly oppose Bill H 3731. Midwives do not need more restrictions. We should have the option to have a home/birth center birth. This bill will take that right away. Please write your legislators to vote NO to Bill H 3731

I think you are dividing midwifery into two camps that are not necessary divisions: Lay midwifery and licensed midwifery. Being “licensed” does not guarantee a good midwife any more than having a “lay” midwife means that she will be inexperienced and “just a doula who decided to catch babies”. Until we start seeing this as a WOMEN’S RIGHTS issue instead of a MIDWIFE’S RIGHTS issue, we will always leave some women in the dust. First and foremost, women should have their rights protected to choose ANY person to attend their birth, license or no license, traditionally trained, whatever. That should be up to her, not the state. And as long as we continue to impose restrictions on her right to choose, midwifery as a whole is at risk.

Vanessa, I understand what you are saying. I agree with you that women should have access to licensed/traditional/unlicensed midwives or no midwife at all.

Midwifery is divided into more than just two camps. :) When I say “lay” I do not mean traditional or unlicensed midwives. I would not refer to these care providers as “lay.” I think lay midwife, in the way it has been defined, is an oxymoron–like calling someone a lay dentist. I’m sorry if I sounded insulting to my midwife friends who choose not to license or practice in places licensing does not exist.

I agree we should work toward reframing the larger fight as a women’s rights issue. But at this moment, in this state, it is about stopping a bill to end licensing.

As a midwife and a home birthing mother, I am speechless. This is archaic nonsense… and makes me wonder if SC prides itself on making laws based on stereotypes rather than research, freedom, and common sense. The very language of the bill itself shows the lack of understanding the government has on this subject. Terrifying that their uneducated perspective has shaped this bill that could be enacted into law- to the great detriment of families all across SC. Thank you for posting this.

Just now reading this, I know this is late. I just found out about a birthing center in SC that has been closed down. Being curious, I looked up the midwives on their web site and discovered the words lay midwife and certified midwife. Trying to figure out the laws in SC, I stumble upon this page. Now, I am a Certified Nurse Midwife. my training includes a Master ‘s Degree in nursing, you did not mention my job in describing 2 different types of training, or did you in SC consider a certified midwife the same as me, a CNM??? I’m just confused about the different types as well and I am a “midwife”!

Hi Ellen, I didn’t mention Certified Nurse Midwives because that is not the group that this bill was targeting. In SC, CNM’s primarily practice in hospitals. There are a handful of exceptions across the state. Licensed Midwives practice entirely out of hospital and that is the group being discussed here.